At 7 AM, a patient demands in a loud, tremulous voice, Where's my ...

[jilianpiloj]

At 7 AM, a patient demands in a loud, tremulous voice, Where's my doctor? The doctor promised to see me first thing in the morning. Call the doctor and say that I'm waiting.. An appropriate response from the nurse would be:
 
  a. Please get ready for breakfast. It's only 7 AM. Your doctor will be in and I'll make sure that you're seen..
  b. Don't yell at me like that; it isn't polite and certainly isn't necessary. I want to help you, but I will not be verbally abused..
  c. You seem very angry that your doctor has not come in yet. Your doctor will be in this morning but not until later. The doctor spends time with everyone..
  d. Your doctor doesn't come to the unit until after breakfast and morning groups are over. Have your breakfast now so you'll be ready when your doctor gets here..

Question 2

Which statement confirms that a nurse approaches working with mentally ill patients from a pathology paradigm?
 
  a. The patient made some important gains during the group session today. The patient was able to identify two strategies for coping with stressors to use after discharge..
  b. It's understandable that the patient keeps getting readmitted. The family dysfunction that the patient has to cope with must be such a burden after each discharge..
  c. During our session today, I hope to be able to get the patient to share more about the family's cultural background..
  d. The patient has not yet fully grasped the concept of being a full partner in the process of care and in setting goals for functioning after discharge..

[kingfahad97]

Answer to Question 1

D
The most therapeutic communication is the one that does the following: addresses the patient by name (this assesses the patient's ability to listen and respond to the nurse) and offers information in a matter-of-fact way (this addresses the well part of the patient's communication, that is, the part in which the patient asks, When is my doctor coming?). The patient's communication is appropriate and needs to be acknowledged in a respectful manner. The best response promotes structure for the patient by offering a plan that suggests a shower (Maslow's hierarchy: the patient will feel better physically while waiting for the doctor) and provides breakfast on the unit with the structure of a reduced-stimulus milieu. (The patient may be escalating, so it is better to order a tray on the unit if the patient is usually able to go to breakfast in the cafeteria.)

Answer to Question 2

B
A pathology paradigm focuses on a disease-based medical model and a view of families as being pathological, pathogenic, or dysfunctional. The competence paradigm focuses on adaptive behaviors, care that is congruent with culture, and a cooperative partnership between patient and health care providers.